Testicular torsion
Testicular torsion is a medical condition characterized by the twisting or rotation of a testicle or spermatic cord, leading to acute pain and swelling. It primarily affects infants, adolescents, and young adult males, with a higher incidence occurring during the early morning hours and more frequently on the left side. The condition can arise from various causes, including direct injury, vigorous physical activity, or inherent anatomical features linked to inadequate connective tissue within the scrotum. Symptoms typically include sudden, severe pain in the scrotum or lower abdomen, swelling, and discolored scrotal skin.
Immediate medical intervention is crucial, as prolonged torsion can obstruct blood flow, resulting in tissue death if untreated for more than six hours. Treatment options include manual untwisting of the testicle, followed by surgical intervention to secure the testicle in place and prevent future occurrences. If significant damage has occurred, removal of the affected testicle may be necessary. Generally, prompt treatment leads to a favorable recovery and preserves fertility through the unaffected testicle. Understanding testicular torsion is essential for identifying symptoms early and seeking timely medical care.
Testicular torsion
ANATOMY OR SYSTEM AFFECTED: Circulatory system, genitals, reproductive system
DEFINITION: A twisting or rotation of the testicle (testis) or spermatic cord on its long axis, causing acute pain and swelling.
CAUSES: Injury, hard physical activity, inadequate connective tissue within scrotum
SYMPTOMS: Acute pain and swelling, discolored scrotal skin
DURATION: Acute
TREATMENTS: Manual untwisting, followed by surgery
Causes and Symptoms
Testicular torsion is most commonly found in infants, adolescents, or young adult males. Roughly half of the cases occur in the early hours of the morning, and cases usually occur on the left side rather than the right. The condition can occur during sleep, rest, game playing, or hard physical activity, but it is more likely to be caused by direct injury. Testicular torsion may also result if the testicle is unusually mobile within its covering in the because of inadequate connective tissue.
Testicular torsion makes itself known by pain of varying degrees either in the lower part of the or in the scrotum itself. The pain intensifies rapidly and is occasionally accompanied by as the testicle becomes swollen and very tender and the scrotal skin becomes discolored. A diagnosis can be made by physical examination.
Treatment and Therapy
Immediate treatment of testicular torsion is necessary. The testicle must be untwisted immediately and blood flow restored to the testicle, the epididymis, and other structures. Otherwise, complete blockage of the blood supply (ischemia) for six hours or more may result in (tissue death) of the testicle. Even a partial loss of can produce atrophy.
Manual untwisting should be followed by surgery within six hours of the onset of symptoms to ensure that the torsion has been undone successfully and that there is no recurrence. An incision is made in the scrotal skin, and the testicle is secured to the scrotum by small stitches. If irreversible damage has been done, the testicle must be removed. The other testicle, which usually remains capable of producing active sperm, is also anchored to prevent torsion on that side. Prompt surgery generally ensures a complete recovery.
Bibliography:
Behrman, Richard E., Robert M. Kliegman, and Hal B. Jenson, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia: Elsevier/Saunders, 2011.
Montague, Drogo K. Disorders of Male Sexual Function. Chicago: Year Book Medical, 1988.
Rajfer, Jacob, ed. Urologic Endocrinology. Philadelphia: W. B. Saunders, 1986.
Rifkin, Matthew D., and Dennis L. Cochlin. Imaging of the Scrotum and Penis. Florence, Ky.: Taylor & Francis, 2002.
Swanson, Janice M., and Katherine A. Forrest. Men’s Reproductive Health. New York: Springer, 1984.
Taguchi, Yosh, and Merrily Weisbord, eds. Private Parts: An Owner’s Guide to the Male Anatomy. 3d ed. Toronto: McClelland & Stewart, 2003.
"Testicular Torsion." Mayo Clinic, 24 Feb. 2022, www.mayoclinic.org/diseases-conditions/testicular-torsion/symptoms-causes/syc-20378270. Accessed 8 Apr. 2024.
“Testicular Torsion.” Urology Foundation, www.theurologyfoundation.org/urologyhealth/male-reproductive-organs/470-testicular-torsion. Accessed 8 Apr. 2024.